Chicago, Illinois – Simone Biles will make her long-awaited return to gymnastics in Chicago on Saturday, with the dreaded "twisties" firmly behind her, in what could be the superstar gymnast's first step on the road towards next year's Olympic games.

The 26-year-old has not taken part in elite competition since her tumultuous campaign at the pandemic-delayed Tokyo Olympics two years ago.

The four-time Olympic gold medalist and 19-time World Championships gold medalist arrived in Japan as one of the stars of Olympic sport, widely expected to crown her legacy with a successful defense of her 2016 Olympics all-around title.

But in what became one of the most gripping dramas of the Tokyo Games, Biles's challenge unraveled dramatically, with the American making a series of uncharacteristic stumbles during early qualification rounds.

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Biles later confided that she felt she had the "weight of the world on my shoulders" and after struggling in the early rounds of the team competition, she withdrew citing mental health issues.

Those same issues prompted her withdrawal from the all-around competition as well as the vault, uneven bars and floor disciplines.

She eventually returned for the balance beam final, opting for a safer-than-usual routine that earned a bronze medal.

Biles attributed her problems to an attack of the "twisties" – a phenomenon in gymnastics where athletes become disoriented and lose their sense of where they are in the air at a given moment, potentially leaving them at risk of injury when they land.

"It's the craziest feeling ever. Not having an inch of control over your body," Biles explained in 2021.

"What's even scarier is since I have no idea where I am in the air, I also have no idea how I am going to land. Or what I am going to land on."

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Biles' decision to withdraw from competition was widely hailed as a watershed moment for the issue of mental health in elite sports, with the gymnast applauded for prioritizing her own well-being before competition.

After confirming her return to competition last month, Biles said she is still undergoing therapy to help her "handle the mental side" of her craft.

"Lots of therapy, I go once a week for almost two hours," she said on Instagram. "I've had so much trauma, so being able to work on some of the traumas and work on healing is a blessing," added Biles, one of dozens of elite gymnasts who suffered sexual abuse at the hands of jailed USA team doctor Larry Nassar.

In a Q&A with fans on Instagram last weekend, Biles said her fear of the "twisties" had been put squarely behind her, even if she admitted to nervousness when returning to the gym.

"When the twisties happen, you go right into the gym and work on it. I took over a year off and THEN came back ... So I was petrified," she said.

"But I'm fine. I'm twisting again. No worries. All is good," Biles wrote.

What the future holds for Biles beyond this weekend remains uncertain.

She has not yet confirmed whether she plans to participate in the Paris Olympics next year.

"For Paris, as of now, I would say, I'll be there regardless," Biles said in a September 2022 interview.

"I just don't know if it will be as an athlete or as an audience member."

This weekend's US Classic has been a happy hunting ground for Biles in the past. In 2018, she used the event as her comeback meet after taking a lengthy break following her gold-medal winning campaign at the Rio Olympics.

She followed that return with two world championship all around gold medals in 2018 and 2019.

This weekend's event in Chicago will also mark a return to competition for reigning Olympic all-around champion Sunisa Lee, who has battled a kidney-related health issue this year.